REASON: “There is another way. One of the chief causes of our current health care malaise is the increasing centralization of the health care budget. In 1965, the health budget of the federal Department of Health Education and Welfare totaled $1.9 billion (about $14 billion in today’s dollars). Then Congress approved legislation establishing Medicare and Medicaid whose costs have increased exponentially since then. Medicaid enrollment increased from 18 million Americans to 68 million now and costs state and federal governments nearly $400 billion last year. Similarly Medicare enrolled 19 million Americans at a cost of $10 billion. Today nearly 48 million Americans are receiving Medicare coverage at a cost of more than $500 billion. If government agencies were able to rein in health care costs, they have had nearly 50 years to prove it. So much for the effectiveness of centralized budgeting.”